The following are summaries and other information related to Proposed Rules that the Department of Commerce and Insurance (DCI) has submitted to the Secretary of State for Publication in the Missouri Register. These rules will not go into effect until the public has had an opportunity to submit written comments, and to attend a public hearing if one is scheduled. Any person may offer comments on a Proposed Rule. The instructions for submitting comments, and the location and date of a hearing if one is scheduled, are located after the text of each rule. Please note that the official text of a Proposed Rule is the version that appears in the Missouri Register, not the draft copy on this site. Refer to the official copy if you wish to submit comments. We hope you find this site helpful and informative.

Proposed Rule Summary Fiscal Note(s) Link to Missouri Register
/Supporting Documents
Small Business
Impact Statement
Division

EMERGENCY AMENDMENT

20 CSR 2197-2.010
Application for Licensure
This amendment updates and clarifies clock hours for licensure.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will cost private entities sixty-five thousand, dollars ($65,000) biennially for the life of the rule.
July 1, 2024 This proposed rulemaking does not have an adverse impact on small businesses. Professional Registration – Massage Therapy

PROPOSED AMENDMENT

20 CSR 2197-2.010
Application for Licensure
This amendment updates and clarifies clock hours for licensure.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will cost private entities sixty-five thousand, dollars ($65,000) biennially for the life of the rule.
July 1, 2024 This proposed rulemaking does not have an adverse impact on small businesses. Professional Registration – Massage Therapy

PROPOSED AMENDMENT

20 CSR 2245-3.005
Trainee Real Estate Appraiser Registration
This amendment outlines the licensing criteria changes established by the Appraisal Qualifications Board (AQB) which take effect January 1, 2026.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
June 17, 2024 This proposed amendment does not have an adverse impact on small businesses. Professional Registration – Appraisers

PROPOSED AMENDMENT

20 CSR 2245-5.020
Application, Certificate and License Fees
This amendment adds a trainee renewal fee and removes redundant language.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will cost private entities six thousand seven hundred twenty-five dollars ($6,725) biennially for the life of the rule.
June 17, 2024 This proposed amendment does have an adverse impact on small businesses. Professional Registration – Appraisers

PROPOSED AMENDMENT

20 CSR 2245-6.018
AQB 2026 Licensure Criteria
This rule outlines the requirements set out by the Appraisal Qualifications Board (AQB) for licensure and certification.

PUBLIC COST: This proposed rule will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed rule will not cost private entities more than five hundred dollars ($500) in the aggregate.
June 17, 2024 This proposed amendment does not have an adverse impact on small businesses. Professional Registration – Appraisers

PROPOSED AMENDMENT

20 CSR 2085-3.010
Fees
This amendment increases various fees.

PUBLIC COST: This proposed amendment will not cost state agency or political subdivision more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will cost private entities approximately one hundred six thousand six hundred sixty dollars ($106,660) annually and one million fifty-six thousand four hundred fifty dollars ($1,056,450) biennially for the life of the rule.
June 17, 2024 This proposed rulemaking does have an adverse impact on small businesses. Professional Registration – Cosmetology/Barbers

PROPOSED RULE

20 CSR 2120-2.106
Preneed Funeral Contract Audit Fee Waiver
To waive the twenty-five dollar ($25) statutory state audit fee paid by consumers who are impacted by the receivership of National Prearranged Services (“NPS”).

PUBLIC COST: This proposed rule will cost state agencies or political subdivisions an estimated forty-six thousand five hundred dollars ($46,500) for the life of the rule.

PRIVATE COST: This proposed rule will save private entities an estimated forty-six thousand five hundred dollars ($46,500) for the life of the rule.
June 3, 2024 This proposed rulemaking does not have an adverse impact on small businesses. Professional Registration – Embalmers

EMERGENCY RULE

20 CSR 2120-2.106
Preneed Funeral Contract Audit Fee Waiver
To waive the twenty-five dollar ($25) statutory state audit fee paid by consumers who are impacted by the receivership of National Prearranged Services (“NPS”).

PUBLIC COST: This proposed rule will cost state agencies or political subdivisions an estimated forty-six thousand five hundred dollars ($46,500) in the time the emergency is effective.

PRIVATE COST: This proposed rule will save private an estimated forty-six thousand five hundred dollars ($46,500) in the time the emergency is effective.
June 3, 2024 This proposed rulemaking does not have an adverse impact on small businesses. Professional Registration – Embalmers

PROPOSED AMENDMENT

20 CSR 2085-8.070
Instructor Renewal and Inactive License Requirements
This amendment allows for distance learning courses for continuing education.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
June 3, 2024 This proposed rulemaking does not have an adverse impact on small businesses. Professional Registration – Cosmetology/Barbers

PROPOSED AMENDMENT

20 CSR 2085-12.010
General Rules and Application Requirements for All Schools
This amendment adds language regarding virtual education.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
June 3, 2024 This proposed rulemaking does not have an adverse impact on small businesses. Professional Registration – Cosmetology/Barbers

PROPOSED AMENDMENT

20 CSR 2263-2.085
Restoration of License
This amendment outlines the requirements for restoration of a license that has been expired or revoked for (2) years or more.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
May 15, 2024

This proposed rule does not have an adverse impact on small businesses.

Professional Registration – Social Workers

PROPOSED AMENDMENT

20 CSR 2040-5.040
Rules for Professional Boxing
This amendment provides guidelines on experience to participate as a professional boxer contestant.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
May 15, 2024

This proposed rule does not have an adverse impact on small businesses.

Professional Registration – Athletics

PROPOSED AMENDMENT

20 CSR 2030-14.020
Definition of Baccalaureate Degree From Approved Curriculum as Used in Section 327.314.2(1)(a), RSMo
This rule is being amended to come into compliance with a statutory amendment via HB 2149 regarding changes that went into effect on January 1, 2024 and to clarify approved course work toward licensure as a Professional Land Surveyor.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
May 15, 2024

This proposed rule does not have an adverse impact on small businesses.

Professional Registration – Land Surveyors

PROPOSED AMENDMENT

20 CSR 2030-14.030
Definition of Sixty Semester Hours from Approved Curriculum as Used in Section 327.314.2(1)(b), RSMo
This rule is being amended to come into compliance with a statutory amendment via HB 2149 regarding changes that went into effect on January 1, 2024, and to clarify approved course work toward licensure as a Professional Land Surveyor.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
May 15, 2024

This proposed rule does not have an adverse impact on small businesses.

Professional Registration – Land Surveyors

PROPOSED AMENDMENT

20 CSR 2030-14.040
Definition of Sixty Semester Hours from Approved Curriculum as Used in Section 327.314.2(1)(c), RSMo
This rule is being amended to come into compliance with a statutory amendment via HB 2149 regarding changes that went into effect on January 1, 2024, and to clarify approved course work toward licensure as a Professional Land Surveyor.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
May 15, 2024

This proposed rule does not have an adverse impact on small businesses.

Professional Registration – Land Surveyors

PROPOSED AMENDMENT

20 CSR 2220-4.010
General Fees
This amendment increases initial and renewal licensing fees.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST:  This proposed amendment is estimated to cost private entities seventy-eight thousand two hundred ninety-five dollars ($78,295) beginning in FY25 and annually thereafter; eighty-seven thousand five hundred dollars ($87,500) beginning in FY 25 and annually thereafter; three hundred twenty thousand six hundred fifty dollars ($320,650) beginning in FY26 and biennially thereafter; and three hundred sixty-two thousand five hundred dollars ($362,500) beginning in FY27 and biennially thereafter for the life of the rule.
May 1, 2024

This proposed amendment does not have an adverse impact on small businesses.

Professional Registration – Pharmacy

PROPOSED AMENDMENT

20 CSR 2150-2.080
Physician Licensure Fees
The board is increasing permanent physician licensure and renewal fees.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will cost private entities one million two hundred fifty-eight thousand dollars ($1,258,000) annually for the life of the rule.
May 1, 2024

This proposed amendment does not have an adverse impact on small businesses.

Professional Registration – Healing Arts

PROPOSED AMENDMENT

20 CSR 2110-2.130
Dental Hygienists
This proposed amendment will allow dental hygienists to administer local anesthetic under the general supervision of a licensed dentist.

PUBLIC COST:  This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST:  This proposed amendment will not cost private entities more than five-hundred dollars ($500) in the aggregate.
May 1, 2024

This proposed amendment does not have an adverse impact on small businesses.

Professional Registration – Dental

PROPOSED RULE

20 CSR 2110-2.134
Oral Preventive Assistant Pilot Project
This rule implements the provisions of section 332.325, RSMo, and creates temporary waivers of provisions of Chapter 332, RSMo, and previously promulgated regulations pursuant to section 332.325, RSMo.

PUBLIC COST:  This proposed rule will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST:  This proposed rule will not cost private entities more than five-hundred dollars ($500) in the aggregate.
May 1, 2024

This proposed rule does not have an adverse impact on small businesses.

Professional Registration – Dental

PROPOSED AMENDMENT

20 CSR 2197-1.040
Fees
This amendment increases the business license renewal fee.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will cost private entities sixty-five thousand, dollars ($65,000) biennially for the life of the rule.
April 15, 2024

This proposed rulemaking does have an adverse impact on small businesses.

Professional Registration – Massage Therapy

PROPOSED AMENDMENT

20 CSR 2010-4.020
Qualifying Programs
This amendment updates a publication date.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
April 1, 2024

This proposed rulemaking does not have an adverse impact on small businesses.

Professional Registration – Accountancy

PROPOSED AMENDMENT

20 CSR 2200-4.200
Collaborative Practice
This amendment reflects changes made to sections 334.104 and 335.175, RSMo, eliminating geographic areas.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
March 1, 2024

This proposed rule does not have an adverse impact on small businesses.

Professional Registration – Nursing

PROPOSED AMENDMENT

20 CSR 2150-5.100
Collaborative Practice Arrangement with Nurses
This amendment reflects changes made to sections 334.104 and 335.175, RSMo, eliminating geographic areas.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
March 1, 2024

This proposed rule does not have an adverse impact on small businesses.

Professional Registration – Healing Arts

PROPOSED AMENDMENT

20 CSR 2267-5.010
Standards of Practice
This amendment deletes language regarding tattoo removal.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
March 1, 2024

This proposed rule does not have an adverse impact on small businesses.

Professional Registration – Tattoo

PROPOSED AMENDMENT

20 CSR 2270-2.031
Examinations
This amendment updates examination requirements.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
February 15, 2024

This proposed amendment does not have an adverse impact on small businesses.

Professional Registration – Veterinary

PROPOSED AMENDMENT

20 CSR 2270-2.041
Reexamination
This amendment updates the requirements for retaking the licensure examination.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
February 15, 2024

This proposed amendment does not have an adverse impact on small businesses.

Professional Registration – Veterinary

PROPOSED AMENDMENT

20 CSR 2270-3.020
Examinations
This amendment updates the examination requirements.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
February 15, 2024

This proposed amendment does not have an adverse impact on small businesses.

Professional Registration – Veterinary

PROPOSED AMENDMENT

20 CSR 2270-4.041
Minimum Standards for Medical Records
This amendment clarifies the term reasonable period of time.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE ENTITY COST: This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
February 15, 2024

This proposed amendment does not have an adverse impact on small businesses.

Professional Registration – Veterinary

PROPOSED AMENDMENT

20 CSR 400-5.900
Suitability in Annuity Transactions
This proposed amendment implements the National Association of Insurance Commissioners (NAIC) Suitability in Annuity Transactions Model Regulation #275.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST:  This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
February 15, 2024

This proposed amendment does not have an adverse impact on small businesses.

Insurance

PROPOSED AMENDMENT

20 CSR 400-13.100
Health Insurance Rates
This proposed amendment requires an actuarial value and cost-sharing factor spreadsheet be included in proposed rates and rate filings for health benefit plans.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST:  This proposed amendment will not cost private entities more than five hundred dollars ($500) in the aggregate.
February 15, 2024

This proposed amendment does not have an adverse impact on small businesses.

Insurance

PROPOSED AMENDMENT

20 CSR 2270-1.021
Fees
This amendment increases renewal fees and cleans up language.

PUBLIC COST: This proposed amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the aggregate.

PRIVATE COST: This proposed amendment will cost private entities sixty-eight thousand, two hundred thirty-five dollars ($68,235) annually for the life of the rule.  It is anticipated that the costs will recur for the life of the rule, may vary with inflation and are expected to increase at the rate projected by the Legislative Oversight Committee.
February 15, 2024

This proposed amendment does have an adverse impact on small businesses.

Professional Registration – Veterinary

EMERGENCY AMENDMENT

20 CSR 2200-6.030
Intravenous Infusion Treatment Administration by Qualified Practical Nurses; Supervision by a Registered Professional Nurse
This amendment will lift the IV push or bolus medication administration restriction on qualified practical nurses and list two (2) additional types of IV medication that qualified practical nurses will not administer.  The need for these changes was determined after the Board of Nursing reviewed a petition for rule review sent by a practicing Licensed Practical Nurse (LPN).  It has been determined that restricting qualified practical nurses from utilizing the IV push or bolus route of medication administration places an undue interruption and delay in patient care.

PUBLIC COST:  This emergency amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the time the emergency is effective. 

PRIVATE COST:  This emergency amendment will not cost private entities more than five hundred dollars ($500) in the time the emergency is effective.
February 15, 2024

This proposed amendment does not have an adverse impact on small businesses.

Professional Registration – Nursing

EMERGENCY AMENDMENT

20 CSR 2231-2.010
Designation of License Renewal Dates and Related Application and Renewal Information
This amendment adds a convenience fee.

PUBLIC COST: This emergency amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the time the emergency is effective.

PRIVATE COST: This emergency amendment will cost private entities seven hundred twenty-three thousand three hundred fifty-nine dollars ($723,359) in the time the emergency is effective.
February 1, 2024

This proposed amendment does have an adverse impact on small businesses.

Professional Registration – Professional Registration

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